The Role of Biofeedback in Improving Vertigo Management in Older Adults. A Controlled Clinical Study in Italy

Introduction: Vertigo significantly impacts the psychosocial functioning in older persons, limiting their ability to carry out daily activities. In older adults, the effects of vertigo are even more severe than in younger populations, as it negatively impacts gait and balance, increasing the risk of falls. This, in turn, has a profound effect on their independence and overall quality of life. Despite the importance of providing integrated treatment, only a few psychological interventions have been proposed for older people. The aim of this study is to evaluate the effectiveness of biofeedback in decreasing the emotional, functional, and physical effects of vertigo in a sample of 190 older outpatients over a 3-month follow-up period. Method: This is a controlled clinical study involving 190 persons of an outpatients of a Medical Centre, aged over 65 years. All patients received treatment as usual; in addition, the experimental group participated in a brief biofeedback training, using Procomp Infinity by Thought Technology Ltd. No biofeedback booster sessions were provided to the experimental group during the 3-- month follow-up. Changes in vertigo severity were assessed using the Dizziness Handicap Inventory (DHI). Results: Repeated ANOVA measures showed that older patients treated with biofeedback reported a reduction in DHI scores after three months, reflecting a decrease in the subjective perception of the disabling impacts of dizziness on their daily living. Discussion: These findings support the effectiveness of integrating biofeedback training into the standard care protocol for older patients living with vertigo. Biofeedback treatment has reduced the effects of dizziness and instability on the day-to-day activities in these patients. Through biofeedback training, these patients learned valuable strategies to manage their symptoms, using techniques such as muscle relaxation and breath control to mitigate the arousal and heightened alertness associated with vertigo episodes. Biofeedback empowered these patients, fostering in them a sense of autonomy and self-efficacy in managing their condition. Conclusion: Despite these promising results, future research should delve deeper into the underlying mechanisms of vertigo in older persons, examining psychological factors and exploring potential correlations with other common comorbidities in this population, such as cardiovascular issues and cognitive decline. Understanding these interconnections will be crucial for developing more comprehensive and effective treatment strategies for older patients with vertigo.